156958 03/05/2008 CITY OF CARMEL, INDIANA VENDOR: 360390 Page 1 of 1
ONE CIVIC SQUARE AMERICAN TECHNOLOGY SOLUTIONS CHECK AMOUNT: $1,334.80
CARMEL, INDIANA 46032 ACCOUNTS RECEIVABLE
1212 S NAPER BLVD SUITE 119 -201 CHECK NUMBER: 156958
NAPERVILLE IL 60540
CHECK DATE: 3/5/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1701 R4351502 15935 10055 -02 1,334.80 PAY STUB SET UP /HOSTI
G-
4
1
.W.mERICAN TECHNOLOC'e SOLUTIONS
,1212 S. Naper Blvd
Suite 119 -201
Naperville, IL 60540 Invoice
Client City of Carmel Invoice 10055 -02
Attn: Diana Cordray
One Civic Square Invoice Date: 2/25/2008
Carmel, IN 46032 PO 15936
Phone: 630 548 -1970
Fax: 630 839 -7252
Description Qty Unit Price Cost
2007 W -2 Database Load with Production and Test File 1 50.00 50.00
2007 W -2 Datamap 1 250.00 250.00
ATS MyW -2 Annual Online Hosting and Storage 1 100.00 100.00
ATS MyW -2 Online Hosting Employee Consent 447 0.40 178.80
ATS MyW -2 Print and Mail Services (includes postage) 945 0.80 756.00
Balance Due: $1,334.80
Payment Due Upon Receipt
Please make check payable to: American Technology Solutions, Corp.
1212 S. Naper Blvd.
Suite 119 -201
Naperville, IL 60540
Thank You! We truly appreciate your business.
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
A Q ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
G,
Payee
T Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Ilia
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
I ALLOWED 20
C 6I tc:fvTnS IN SUM OF
vd
ON ACCOUNT OF APPROPRIATION FOR
rT�� Z
Board Members
OD O# or INVOICE NO. ACCT #/TITLE AMOUNT
I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund